【摘要】 目的探讨在黄体中期促性腺激素释放激素激动剂(GnRHa)长方案中促性腺激素(Gn)刺激时间对于体外受精-胚胎移植(IVF-ET)结局的影响。方法回顾性分析了2009年1月到2011年12月在武汉大学人民医院生殖中心首次接受IVF-ET治疗的1 119例患者的临床资料,分析患者促排卵情况与Gn刺激时间的分布情况。并将患者按照Gn刺激时间分为7组,比较各组患者的一般情况、卵巢储备功能、IVF治疗经过、IVF治疗结局等,研究不同Gn刺激时间与IVF结局的关系。结果全部患者按Gn刺激时间分为≤9d、10d、11d、12d、13d、14d、≥15d,共7组,各组病例数及构成比分别为:57(5.1%)、137(12.2%)、247(22.1%)、272(24.3%)、192(17.2%)、122(10.9%)、92(8.2%),其中Gn刺激时间为12d组比例最高。平均Gn刺激时间为(11.8±1.8)d,临床妊娠率(CPR)为47.3%。各组的平均年龄、不育年限及卵巢储备情况无差异。Gn刺激时间为11～13d组IVF结局最好,临床妊娠率、活胎分娩率高,流产率和周期取消率低;而刺激时间过长(≥14d)和过短(≤10d)者IVF结局均较差。结论 Gn刺激时间可以初步预测IVF结局,Gn刺激时间过长与过短都可能预示不良的IVF结局。更多还原

【Abstract】 Objective To explore the effect of gonadotropin(Gn)stimulation time on the in vitro fertilization(IVF)outcome in luteal phase GnRHa long protocol.Methods Clinical data of 1 119 women who underwent their first IVF attempt with GnRHa long protocol from Jan 2009 to Dec 2011 in our hospital were retrospectively analyzed.Seven groups were established in terms of different Gn stimulation time.The clinical characteristics,markers of ovarian reserve,IVF treatment experiences and IVF outcomes were compared among the different groups.Results The number and the proportion of patients in each group were as follows:57,5.1%(≤9dgroup);137,12.2%(10dgroup);247,22.1%(11dgroup);272,24.3%(12dgroup);192,17.2%(13dgroup);122,10.9%(14dgroup);92,8.2%(≥15dgroup).It was revealed that the proportion of patients was highest in the 12dgroup.The average Gn stimulation time was(11.8±1.8)d,and the clinical pregnancy rate was 47.3%.There was no difference in age,infertility years and ovarian reserve among the different groups.The best IVF outcomes were achieved in the 11d,12d,and 13 dgroups,which was evidenced by the high clinical pregnancy rate(CPR)and live birth rate(LBR)and the low abortion rate and cycle cancellation rate.The IVF outcomes were poor in the long-time stimulation groups(≥14dgroups)and short-time stimulation groups(≤10d groups).Conclusion The Gn stimulation time may help predict the IVF outcomes.Both long-time and short-time Gn stimulations indicate poor IVF outcomes.更多还原